Four Corners Regional Care Center, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

2005-NCF-109 Issued in UT

Legal business name

FOUR CORNERS REGIONAL CARE CENTER, INC.

Practice address

818 N 400 W
Blanding, UT 84511-3417

Phone

(435) 678-2251

Fax

(435) 678-2326

NPI assigned

Jul 19, 2005

Last updated

Jun 10, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

HORIZON WEST HEALTHCARE OF UTAH, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Larry E Bear

Title

Chief Executive Officer

Phone

(916) 624-6230

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1669471975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 SIERRA COLLEGE BLVD",
            "address_2": "SUITE #190",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "956773906",
            "telephone_number": "916-624-6230",
            "fax_number": "916-624-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 N 400 W",
            "city": "BLANDING",
            "state": "UT",
            "postal_code": "845113417",
            "telephone_number": "435-678-2251",
            "fax_number": "435-678-2326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR CORNERS REGIONAL CARE CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HORIZON WEST HEALTHCARE OF UTAH, INC.",
        "enumeration_date": "2005-07-19",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "BEAR",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "916-624-6230",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "UT",
            "license": "2005-NCF-109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Sloane Fife
• Mahana S Fisher, M.D.
• Jeffrey Fitzgerald
• Four Corners Health Care
• Four Corners Medical Supply
• Vickie Foy, PNP
• Global Pain Clinic LLC (Revival Physical Therapy)
• Madison A Gray
• Guardian Flight LLC
• Shane Gurley, PHARMD

• Assisted Living Facility in Blanding, UT
• Providers in Blanding, UT by specialty
• Assisted Living Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.